Asunto(s)
Fuga Anastomótica/diagnóstico , Conductos Biliares/lesiones , Fístula Biliar/etiología , Colestasis/diagnóstico , Hemobilia/diagnóstico , Adolescente , Aloinjertos/diagnóstico por imagen , Aloinjertos/patología , Anastomosis Quirúrgica/efectos adversos , Fuga Anastomótica/etiología , Fuga Anastomótica/cirugía , Conductos Biliares/patología , Conductos Biliares/cirugía , Atresia Biliar/cirugía , Fístula Biliar/diagnóstico , Fístula Biliar/cirugía , Bilirrubina/sangre , Biopsia con Aguja/efectos adversos , Biopsia con Aguja/instrumentación , Colestasis/sangre , Colestasis/terapia , Constricción Patológica/sangre , Constricción Patológica/diagnóstico , Constricción Patológica/cirugía , Descompresión , Drenaje , Hemobilia/sangre , Hemobilia/etiología , Hemobilia/cirugía , Humanos , Biopsia Guiada por Imagen/instrumentación , Hígado/diagnóstico por imagen , Hígado/patología , Trasplante de Hígado/efectos adversos , Imagen por Resonancia Magnética , Masculino , Agujas/efectos adversos , Ultrasonografía IntervencionalAsunto(s)
Coagulación Sanguínea , Colecistitis/complicaciones , Hemobilia/complicaciones , Pancreatitis/etiología , Anciano , Colecistectomía Laparoscópica , Colecistitis/sangre , Colecistitis/diagnóstico por imagen , Colecistitis/cirugía , Femenino , Hemobilia/sangre , Hemobilia/diagnóstico por imagen , Hemobilia/cirugía , Humanos , Pancreatitis/diagnóstico por imagenRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Aneurisma Falso/sangre , Aneurisma Falso/patología , Hemorragia Gastrointestinal/sangre , Hemorragia Gastrointestinal/genética , Colecistitis/patología , Hemobilia/sangre , Espectroscopía de Resonancia Magnética , Aneurisma Falso/genética , Aneurisma Falso/metabolismo , Hemorragia Gastrointestinal/metabolismo , Hemorragia Gastrointestinal/patología , Colecistitis/metabolismo , Hemobilia/patología , Espectroscopía de Resonancia Magnética/instrumentaciónRESUMEN
Traumatic hemobilia consists of hemorrhage into the biliary tract as a result of abdominal trauma. The classical triad of biliary colic, jaundice and upper gastrointestinal bleeding is not a constant finding, and clinically silent hemobilia has been reported. The treatment of choice is selective embolization, but spontaneous cessation of bleeding can occur, especially in mild forms. We report a case of occult traumatic hemobilia in which the diagnosis was suggested by transitory changes in ultrasonography and hepatic biochemistry.
Asunto(s)
Vesícula Biliar/lesiones , Hemobilia/etiología , Cinturones de Seguridad/efectos adversos , Heridas no Penetrantes/etiología , Accidentes de Tránsito , Anciano , Conmoción Encefálica/etiología , Hígado Graso/complicaciones , Vesícula Biliar/diagnóstico por imagen , Enfermedad de Gilbert/sangre , Enfermedad de Gilbert/complicaciones , Hemobilia/sangre , Hemobilia/diagnóstico por imagen , Humanos , Hiperbilirrubinemia/etiología , Masculino , Tomografía Computarizada por Rayos X , Ultrasonografía , Heridas no Penetrantes/sangre , Heridas no Penetrantes/diagnóstico por imagenRESUMEN
Poly (2-hydroxyethyl methacrylate) (PHEMA) particles of cylindrical and spherical shape were developed as a preparation for tumor treatment or control of hemorrhage by blocking their blood supply. In this report, PHEMA particles were used for the management of hemobilia, that is, bleeding into biliary passages. The origin of hemobilia in 31 patients was localized by selective angiography. With the objective of prophylaxy of hemorrhage, selective embolization with PHEMA particles of the branches of the hepatic artery responsible for the supply of blood to the focus of damage was used in 18 patients. This low-trauma method allowed either a complete control of bleeding or, at least, intraoperative blood loss was reduced more than twice. Histological investigation of the occluded blood vessels showed that the thrombus was attached to the particles and was reinforced by the porous structure of the polymer. A hypercoagulation reaction was observed in the postembolization period. This allowed correction of the hypocoagulation in the hemostasis system.
